BROKEN ARM

Types of Arm Fractures in Children

Arm fractures can occur in the following areas:

• Radius bone at the wrist
• Radius and the ulna, and
• Ulna (close to the elbow)

In most cases, fractures of the radius occur together with injuries to the ulna. Since the bones are close together, the other bone is usually affected when one of the bones is injured. Here are the types of broken arms:

Galeazzi fracture

Galeazzi fracture occurs when the radius alone fractures from the ulna. In this case, the end of the ulna usually dislocates at the wrist.

Plastic deformation

This type of arm fracture affects the radius or ulna. Since a child’s growing bones are more elastic than adults, they can deform (instead of breaking) when they experience excessive force. The deformity remains even after the force has been removed.

Monteggia fracture

Monteggia fracture affects the ulna and radius. In this type of arm fracture, the ulna breaks while the elbow dislocates at the top of the radius.

Nightstick fracture

Nightstick fracture is an arm fracture that occurs when the ulna breaks independently of the radius. Since the ulna extends from the tip of the elbow to the wrist, it can break easily when a child falls and lands on his or her elbow.

The Orthopedic Trauma Program ensures seamless care for musculoskeletal injuries through a collaborative approach with the Emergency Department. This teamwork begins with accurate and swift diagnosis, followed by developing a comprehensive treatment plan tailored to the patient’s unique needs. The program facilitates communication between specialists to ensure every aspect of care, from surgery to physical therapy, is expertly managed. By prioritizing coordination, the program enhances recovery outcomes and maintains a high standard of precision and efficiency in treating these complex injuries.

Causes of Broken Arms in Children

Broken arms are usually found in active children. They occur while playing and participating in sports. In most cases, broken arms are a result of impact injuries, such as a child falling directly on the arm, a child falling on an outstretched arm, or a direct blow to the arm of the child.

Signs and Symptoms of A Broken Arm

Some of the symptoms of a broken arm include the following:

• Tenderness and swelling
• Difficulty rotating or turning the arm
• Severe pain
• Numbness in the arm or elbow
• Deformity of the arm, wrist, or elbow.

Also, your child may support the fractured arm with the other hand.

How Does the Medical City Children’s Orthopedics and Spine Specialists Medical Practicer Help Children who are Athletes?

Our medical practice is dedicated to supporting athletes across the spectrum, whether you’re an established competitor, a young beginner, or anywhere in between. Here’s how they help you achieve peak performance and ensure your well-being:

• Comprehensive Evaluation and Diagnosis: They thoroughly assess athletic injuries and conditions using cutting-edge technology and techniques to pinpoint the issue swiftly.
• Tailored Treatment Plans: Each athlete receives a customized treatment plan designed to accommodate their unique needs and goals, ensuring a swift and effective recovery.
• Wide-reaching Expertise: The team is skilled in addressing an extensive range of sports-related injuries, from minor strains to complex conditions, offering expert guidance every step of the way.
• Support for All Levels: Whether you’re gearing up for professional competition or taking your first steps in sports, their seasoned professionals are ready to assist, providing the same level of care and commitment to everyone.
• Focus on Injury Prevention: Beyond treating injuries, they emphasize preventing them. Through education and training programs, they equip athletes with the knowledge needed to stay safe and optimize performance.

By prioritizing individual care and offering expert support, the division enhances athletic experiences while safeguarding health.

Soft Tissue Injuries That Can Occur In The Arm

Issues with the soft tissues usually affect the tendons in the arm. They are often a result of overusing the wrist or elbow. For instance, ‘tennis elbow’ (also referred to as lateral epicondylitis) refers to a condition where the tendons on the external surface of the elbow are inflamed and sore. Also, tendons on the inside surface of the elbow can get sore (a condition referred to as ‘golfer’s elbow’ or medial epicondylitis). The general treatment for tendon problems involves resting the wrist and arm and not giving room for any movement that leads to the problem. Wearing elbow or wrist supports and physiotherapy can help in this situation.

Diagnosing A Broken Arm in Children

A broken arm often occurs when a child falls on an outstretched hand, resulting in bending and rotational forces that cause the bone to break. The arm may appear bent, making it easier to diagnose. During a visit, we begin with a thorough physical examination of the child’s arm, wrist, and elbow, checking for any deformity, swelling, tenderness, and difficulty in moving the affected arm.

In most cases, we recommend an X-ray to confirm the diagnosis and assess the severity of the injury. X-rays are a primary diagnostic tool that uses small amounts of radiation to produce images of bones, helping to determine the type of arm fracture your child has.

To provide a more comprehensive evaluation, the doctor may order additional imaging tests:

• Magnetic Resonance Imaging (MRI): This test uses large magnets, radio frequencies, and a computer to create detailed images of the body’s structures. MRIs are more sensitive than X-rays and can detect smaller fractures before they worsen.
• Computed Tomography (CT, CAT scan): CT scans combine X-rays and computer technology to produce cross-sectional images, offering a detailed view of the body both horizontally and vertically.
• Bone Scan: A bone scan involves a radioactive substance to evaluate bones, particularly useful for detecting stress fractures and toddler fractures, for which an X-ray may not show.

By utilizing these diagnostic tools, our doctors implement the correct treatment, tailored specifically to the type and severity of the fracture.

Apart from a physical examination and X-rays, the doctor will diagnose a broken arm through the following means:

Motion tests

A series of motion tests to determine how the injury affects the movement and dexterity of the child.

Nerve assessment tests

These tests provide information about damage or compression of any nerves in the arm or hand of the child. The more information the doctor can gather about a child’s condition, the better the child’s treatment.

Treatment of A Broken Arm – Broken Arm Doctors

The type of treatment our doctors will use for a child’s broken arm depends on the specific type of fracture, the age, and the development of the child.

Non-surgical treatment

If the arm fracture sustained by the child does not appear severe and the bone appears correctly positioned, the doctor will place the broken arm in a cast for the bone to heal.

The doctor can manipulate the bone in a procedure referred to as a ‘closed reduction’. The doctor performs this procedure on children with a simple, displaced fracture (a condition where the bone does not align properly) to reposition the bone. In this treatment method, the doctor aligns the breakage so that the bones are perfectly aligned without a surgical procedure. Local anesthesia makes the area numb.

Performing the Procedure

Closed reduction is a nonsurgical method where the doctor realigns the bone fragments externally. Typically, an anesthetic is given through an IV in the arm to ensure comfort during the procedure. The goal is to adjust the bone pieces so they align correctly, avoiding the need for surgery.

Post-Procedure Care

Once the bone is realigned, it is essential to keep it stable. This is achieved by placing a cast or splint on the affected area and holding the bones in their new, proper position to promote healing. This careful post-procedure management is crucial to a successful recovery.

After completing the procedure, the doctor will use a splint or cast to keep the bone in place while it heals. Depending on the severity of the fracture and the degree of swelling after repositioning the bone, the doctor may recommend a splint to reduce the swelling before applying a cast.

Splints are typically used for minor breaks. They provide support by stabilizing the broken bone on one side and immobilizing the area to aid in proper bone alignment during healing. In emergencies, splints hold a joint steady while the individual is transported to a medical facility, offering immediate but temporary stabilization.

Casts, on the other hand, offer more robust protection. They are designed to completely immobilize the injured area, including the bone above and below the joint, ensuring that the bone remains in the correct position as it heals. This makes casts the preferred choice for more serious fractures once the initial swelling has subsided.

By understanding the distinct roles of splints and casts, healthcare providers can choose the most appropriate method for effective bone healing.

Surgery for a broken arm

The doctor will recommend surgery if:

• The fracture appears severe
• The arm fracture broke the skin
• The fracture affected the growth plate
• The doctor cannot reposition the fracture externally

In this situation, a pediatric anesthesiologist will give the child anesthesia to prevent them from feeling pain and sensation while the surgery is going on. A surgeon will then make an incision to have access to the bones in the arm. The surgeon will align the bones properly.

Casts

The surgeon may recommend using a cast, metal pins, plate, and screws, or an external fixator to keep the fracture stabilized and ensure the bones remain in the correct position while healing. Your child’s doctor will inform you about the most effective way to keep the injured arm immobilized while healing.

When it comes to treating broken arms, various types of casts are commonly used, each designed for specific injuries and recovery needs. Here’s a breakdown of some typical options:

1. Short Arm Casts

• These casts cover the area from the elbow down to the hand.
• They’re typically used for treating fractures of the forearm or wrist.
• In some instances, they also play a role after surgery to stabilize the arm.

2. Long Arm Casts

• Extending from the upper arm to the hand, these are more comprehensive.
• They are ideal for fractures involving the upper arm, elbow, or forearm.
• Post-surgery, long arm casts are employed to keep the arm stable and protect the healing area.

3. Arm Cylinder Casts

• These reach from the upper arm to the wrist.
• Mostly utilized for maintaining the position of elbow muscles and tendons, especially after dislocations or surgical procedures.

Each type of cast serves a specific function during the healing process, providing support and immobilization crucial for recovery. When choosing a cast, healthcare providers consider the nature and location of the injury, aiming to optimize the healing environment.

Understanding Traction and Its Role in Treating and Healing a Broken Arm

Traction is a medical technique designed to aid in the healing process of broken bones, such as a fractured arm. This method involves applying a gentle and continuous pulling force to the affected area. By doing so, it assists in aligning the bones properly.

How Does Traction Help?

• Bone Alignment: Traction carefully stretches the muscles and tendons surrounding the fractured bone, encouraging the bones to line up correctly. Proper alignment is crucial for the bone to heal naturally and effectively.
• Pain Reduction: The steady pull applied by traction can also alleviate painful muscle spasms. These spasms often accompany a fracture due to the muscles tightening around the broken area.
• Healing Facilitation: By ensuring that the bones are properly aligned, traction supports the body’s natural healing process. This can lead to a smoother and potentially quicker recovery.

Overall, traction plays a vital role in the orthopedic treatment of broken arms by promoting proper bone healing and minimizing discomfort during the recovery period.

Complications of a Broken Arm

Decrease in motion

The limited motion usually occurs after treating broken arms. For example, limited motion can occur in the elbow and wrist joints, and also a limitation in rotating the arm. In other words, an arm fracture can make it difficult for a child to turn a door handle or open a jar.

Inadequate healing of the fracture

Arm fracture complications can make the bones of the arm not heal effectively; thereby, causing persistent pain. This is usually the case in broken arms where the bone is severely damaged. In this case, a repeat surgery implementing bone grafting usually provides a solution.

Infection

Infection can occur after any surgery. When infection occurs after fixing a broken arm, the metal plate and screws may need removal to stop the infection.

Painful metal implants

The hardware (i.e. metal implants) used during the surgical procedure to allow healing is noticeable to the touch under the skin, and this can be painful. If the hardware causes any discomfort, doctors can remove it at least a year after the surgery.

Recovery of a Broken Arm

The length of time a child wears a cast depends on the severity of the fracture. For a stable arm fracture, such as a buckle fracture, the cast will remain on the child for 3 to 4 weeks. A Monteggia fracture and other severe fractures need immobilization for about 6 to 10 weeks. After removing the cast, the joints in the wrist and elbow may remain stiff for 2 to 3 weeks. The stiffness will wade off on its own, so there’s no need for any physical therapy.

Also, the arm bones may experience weakness as a result of immobilization in the cast. This will only last for a short period. The child must avoid playing on monkey bars and other playground structures for about 3 to 4 weeks after removing the cast so that the bones in the arm can regain their normal strength. If the fracture affects the growth plate at the end of the bone, it could impede the development of the bone. As a result, the doctor may recommend scheduling follow-up visits for about one year to ensure normal growth.

Request An Appointment For Your Child’s Broken Arm

The Medical City Children’s Orthopedics and Spine Specialists have been providing excellent broken arm fractures for many years. We focus on improving the long-term health of your child’s bones. If your child is in pain as a result of a broken arm, call one of our compassionate experts at 214-556-0590 to schedule an appointment with us. Finally, we offer personalized treatment and urgent pediatric care services at all of our four locations — Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX.  If you notice any symptoms of a broken arm in your child, don’t hesitate to contact us to avoid complications.

Orthopedic Upper Extremity Program

Our Orthopedic Upper Extremity Program is dedicated to treating a wide range of hand, arm, and shoulder injuries. We ensure that each child receives specialized care for their specific needs, enhancing their recovery and long-term health.

Orthopedic Trauma Program

In collaboration with Emergency Department staff, at hospitals and Emergency Care Centers, our Orthopedic Trauma Program delivers coordinated care for children with musculoskeletal injuries. This program is ideal for urgent situations, ensuring your child gets the immediate attention they need when dealing with serious injuries like broken arms.

Orthopedic Fracture Care Clinic

We understand that not all injuries require an Emergency Department visit but still need prompt evaluation and care. Our Orthopedic Fracture Care Clinic is committed to providing timely and effective treatment for children and adolescents with musculoskeletal issues.

These programs are designed to provide comprehensive support and treatment for patients, ensuring their child receives the best possible care for any orthopedic issues. Whether it’s a simple fracture or a complex injury, our team is ready to assist with expertise and compassion.

Our Orthopedics and Sports Medicine medical practice offers a comprehensive range of services tailored to meet the needs of children and young athletes. Our team specializes in the diagnosis and treatment of various orthopedic conditions and provides expert care for fractures, scoliosis, and sports injuries, ensuring that young patients receive optimal recovery support.

In addition to traditional treatments, the center is equipped with advanced surgical and non-surgical techniques to address complex musculoskeletal issues. Their rehabilitation programs are designed to promote healing and restore mobility, all in a child-friendly environment.
Furthermore, they collaborate with physiotherapists and other specialists to deliver personalized care plans. This holistic approach ensures that every patient receives tailored treatment for their specific condition, guiding them on the path to a swift and effective recovery.

What Services Are Provided by the Fracture Care Clinic?

The Fracture Care Clinic specializes in addressing the needs of children and teenagers who experience injuries and musculoskeletal issues. These conditions involve bones, muscles, and soft tissues that aren’t severe enough for an emergency room visit but still demand swift assessment and treatment.

Key Services:

• Prompt Evaluation: The clinic ensures rapid assessment of injuries to determine the best course of action for recovery.
• Non-Emergency Care: It’s a perfect option for conditions that are urgent but not life-threatening, providing a middle ground between waiting for a regular appointment and visiting the emergency department.
• Specialized Care: Staffed by professionals experienced in pediatric orthopedics, the clinic offers expert care tailored to young patients.

This clinic is an invaluable resource for families needing immediate attention to musculoskeletal concerns without the intensity of an emergency room setting.

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Footnote:

American Academy of Orthopaedic Surgeons: Forearm Fractures in Children